Mallu Reddy, MD, Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A62958 Issued in CA

Legal business name

MALLU REDDY, MD, INC

Practice address

301 S la Cadena Dr
Colton, CA 92324-3419

Phone

(909) 623-4050

Fax

(909) 620-5259

NPI assigned

Mar 19, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Alex Hernandez III

Title

Administrator

Phone

(909) 623-4050

Specialties & licenses 1

Addresses

Other names 1

• REDDY CARE MEDICAL COLTON Doing business as

Tax ID family

Mallu Reddy MD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Mallu Reddy, M.D. Inc.

  • Internal Medicine Physician
  • Pomona, CA
  • NPI 1184821340
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mallu C Reddy, MD

  • Internal Medicine Physician
  • Pomona, CA
  • NPI 1942278221
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1426723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426723200000",
    "number": "1447644182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1196 N PARK AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917683027",
            "telephone_number": "909-623-4050",
            "fax_number": "909-620-5259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S LA CADENA DR",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923243419",
            "telephone_number": "909-623-4050",
            "fax_number": "909-620-5259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALLU REDDY, MD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-19",
        "last_updated": "2015-03-19",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "ALEX",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "909-623-4050",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A62958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "REDDY CARE MEDICAL COLTON",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sara Malik, MS
• Yousaf Iftikhar Malik, MD
• Aldin Malkoc, MD
• Anil D Mall, M.D.
• Claire Elizabeth Malley, MD
• Jessica Lee Malstrom
• Marko Michael Mamic, D.O.
• Benjamin Morales Manacop III
• Amir Manafi, MD
• Sharan Kaur Mangat

• Internal Medicine Physician in Colton, CA
• Providers in Colton, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.